Basic communication
communication in health care:
process of exchanging messages( def )
health care workers
patients
patients’ families
students and visitors
administrators and buisness contacts
verbal-
use of language and words
most effective form of communication
GOALS:
establish rapport
obtain info from patients
confirm understanding
relay info to other healthcare workers
give instructions to patients
tone of voice-
expresses speaker’s feelings
patients can pick up on fear, agitation, calmness, and confidence
adjust tone of voice appropriately to the situation
language choice-
translate med terms into layment terms
health care workers must avoid talking down to patients by over simplifying their language
be careful to enunciate words and avoid mumbling
theraputic communication-
patient centered communication in which the patient is looked at as a person
improves patient satisfaction and improves health outcomes
develop a rapport
speak clearly and slowly
introduce yourself
use language the patient can understand
show leadership but dont impose or give advice
be honest with the patient
use open ended questions( descriptive answers )
use closed questions when specific info is needed( yes or no )
ask one question at a time
do not interrupt
allow them to discuss his/her feelings and concerns
listen to what hteu say
allow them enough time to answer the question
ask for their permission before performing a procedure
tell them what youre going to do
apologize for any discomfort
be aware of your nnon-verbal communication
selecting the correct form
would the mesage be better delivered orally?
does the message require a written record?
what format?
writing memos
often used in the health care industry
standard parts:
TO:
FROM:
DATE:
SUBJECT:
body
the five W’s
who is the audience?
what is the purpose of the message?
why is the message important?
when did or will the event take place?
where did or will the event take place
nonverbal communication
used in addition to or as a substitue for language
includes:
eye contact and facial expressions
gestures and body language
physical appearance
touch
proximity
eye contact and facial expressions
direct eye contact sends a powerful and positive message
smiles and other facial expressions
be concious of interpritation and own expression
gestures and body language
people use their bodies instead of words
posture also conveys a message
read and use gestures and body language
physical appearance
uniformas send the message that they belong to the health care field
physical appearance is also expressed by grooming
touch
touch can communicate many things
touch can also be misinterpreted
be concsientious to touch patients with only kindess and respect
proixmity
physical space between people
includes:
distance between people
height
odor
sensitivity and professionalism are required when patient proximity is an issue
COMMUNICATION PROCESS
communication is a process
the sender-reciever model is a way to break down the process into steps
use with active listening
sender reciever model
the sender is the person who encodes, or gives information
the reciever is the person who decodes or accepts the information
the message is the information that is being communicated
other elements include frame or reference and feedback
active listening skills
show interest
be alert
maintain eye contact
avoid interrupting
pay attention
avoid thinking ahead for a response
try to ignore personal prejudices
ignore distractions by moving to a quiet place
watch the speaker closely for nonverbal condtradictions
maintain a positive attitude
restatement, reflection, and clarification
restatement involves reoeating the message back to the sender in the recievers own words
reflection involves responding with empathy
clarification occurs when the reciever asks the questions to get a more concise explination or to clear up anh confusion about the message
other effective communication skills
be conscious of your own body language, including posture and eye contact
avoid any display of anger
speak softly, slowly, and clearly
INTERPERSONAL COMMUNICATION
attitudes and behaviors
adopt acceptable attitudes and behaviors
courtesy
respect
sensitivity to boundaries
empathy
courtesy
involves being polite, gracious, helpful and considerate
overcome personal and other issuess unrelated to the job
respect
approach anotehr person with a feeling of esteem or regard
theme in any study of communication in health care
without proper respect, communication can quickly veer towards failure
sensitivity to boundaries
sensitivity is ability to see and appreciate the personal traits of others
sensitiivity to boundaries is ability to recognize and observe the emotional and physical limits of others
empathy
ability to share in someone else’s feelings or emotions
patients who are lonely or facing serious surgeries or terminal illnesses are in special need of emptahy
diversity
put aside all personal and cultural bias
treat all people fairly, equally, and with sensitivity
be aware that others have cultural and personal biases
diversity includes the following:
race
gender
age
ethnicity
socioeconomic status
occupation
hralth status
religion
sexual orientation
criticism
constructive criticism can build people up and inspire them to do better
non-constructive criticism serves only to tear people down and discourage them
be prepared to accept and give constr. criticism
accepting constructive criticism
when people recieve constr. criticism, they should appreciate it
people who recieve criticism shoukd avoid making excuses, getting angry, and blaming others
giving constructive criticism
when giving constr. criticism, people should put themselves in the other’s place
choose words carefully and speak kindly and considerately
allow the other person a moment to accept what is said
group communication
health care workers must effectively communicate with their colleagues
health care workers must put aside all personal prejudice and treat team members fairly and equally and so that they can communicate effectively in group situations
communication patterns
chain-of-communication pattern
wheel-of-communication pattern
all-channel-communication pattern
group interaction
conformity occurs when individuals change their opinions or beliefs to match that of the group
in some instances, conformity can be bad, as it may cause people to go against their beliefs or values
in the professional world. conformity can be good. it is good when people conform to behave appropriately in the professional atmosphere
group participation
understand the group goals and own roles within the group
in meeting situations, group members must:
be prepared
use active listening skills
focus on the discussion
share relevant ideas
respect others
follow through with assignments
directions
in the health care field, it is critical that directiobs are carried out correctly
in order for this to occur, directions must be both given and taken accurately
giving directions
when giving directions:
keep instructions simple and brief
give directions in a logical, chronalogical order
adjust language and complexity to the patient’s ability
have the patient restate
correct any misunderstanding
following directions
when following directions;
be diligent
ask questions
take notes
follow through
COMMUNICATION BARRIERS
many types of barriers
a communication barrier:
make it difficult to send a clear message
understand message being sent
provide apropriate feedback
personal communication barriers
can occur within either participant in communication
can result from emotions and attitudes, resistance to change, preconceptions, and self absorption
can form out of orejudice and personality, including traits such as closed-mindedness, judging, belief in stereotypes, and preachign and moralizing
emotions and attitudes
extreme emotions interfere with ability to concentrate
attitudes can create barriers
these attitudes may include:
prejudice
se,ective comprehension
complacency
preconceptions
preconceptions are similar to prejudice
typically directed toward a single person, rather than a group
create barriers when people disregard what another is saying simply because they disagree or they do not care for the other person
resistance to change
health care workers may have resistance themselves, or they may have to deal with a patients resistance
be flexible and open-minded
communicate the benefits of change in a positive way to patients
self absorption
when people are preoccupied they can miss much of the message coming from another person
put own issues aside and focus 100% on their patients
overcoming personal and psychological communication barriers
poor attitudes alienate patients
patients will attach little value to what it said
lean to overcome or put aside personal psychological barriers
CULTURAL BARRIERS
cultural commjunicationn barriers
values, beliefs, anf customs that are common among a group of people
barriers include:
language
health practices and beliefs
language
eye contact
religion
language
most obvious communication barrier
speak slowly and ise simple words, gestures, or pictures
find an interpreter if possible
health beliefs
beliefs about health practices and treatments may conflict
patient has the right to refuse treatment
be sensitive to these cultural conflicts
work with patients to make sure that they are getting the required treatment and care
eye contact
differing cultural views on what is or is not appropriate eye contact can inhibit good communication
in some cultures, direct eye contact is viewed as disrespectful
respect and adjust to the patient’s cultural differences
religion
organized beilief in a higher power
influence many aspects of people’s lives including birth, life, diet, illness, and death
be aware of common religous influences
PHYSICAL BARRIERS
physical commnication barriers
patients who are physically or mentally impaired provide challenges when tryong to communicate important health information
physical challenges that can effect communication include:
problems with speech, hearing, and vision
mental challenges
current physical or mental state
hearing challenges
deaf patients:
use sign language if possible
utilize body language and gestures
face the patient when speaking
hard of hearing patients:
face the patient when speaking
speak clearly at a moderate pace
keep the sentences short and uncomplicated
vision challenges
blind patients:
speak softly ro them
announce your presence
describe pricedures as they are happening
explain unusual noises
low vision patients:
volunteer to turn on more lights
use bigger body gestures
speech challenges
aphasia
speech problems that originate with damage to the brain
patients may struggle both with speaking and writing
health care workers must be patient and considerate by speaking clearly and simply
dysarthia
trouble with oarticular sounds and slurring words
health care workers shoukld be patient and encourage these patients to speak slowly and to use hamd gestures
physidally or mentally challenged
when interacting with a patient in a wheelchair, it is respectful for te health care worker to also be seated
health care workers must also be sensitive to patients who are mentally or emotionally challenged. they must be prepared for anything and treat these oatients with cakmness respect and courtesy
current physical or mental state
patients may not be abke to communicate clearly if they are:
very ill or in ohysical pain
on strong medication
upset or confused
experiencing a great deal of stress
understand the context of the situation when interacting with patients
enviromental communication barriers:
noise and activity levels
physical arrangement and comfort
time
noise and activity levels
control the noise and activity levels in common areas where patient haelth care worker conversations might take place
physical arrangement and comfort
partitions and dividers
room temperature
make the physical arrangement welcoming and comfortable
time
communication barrier if not enough of it is devoted to interacting with a patient
COMMUNICATING WITH PATIENTS
interaction
patient interaction
feeling confident comfortable, and competent during patient interaction takes practive and expirience
patient interaction involves seberal stages:
preparation
introduction
assessment
treating and monitoring
feedback and follow up
preparation
take a moment to prepare
review the patient’s chart:
patient’s name
health history
chief complaint
special needs or precautions
introduction
enter the room calmly and formally introduce yourself
name
position
purpose for being there
be positive and genuine
assessment
make observations and evaluate a patient’s condition
assessment includes the patient’s:
appearance
personality
attitude
reaction to the health care worker
vital signs
treating and monitoring
treating a patient involves reading and following doctor’s orders
describe the procedure in layment terms
monitor the patient, looking for any signs of change, good or bad
feedbacl and follow up
assess the patient again
ask them how they are feeling
take vital signs
give patients feedbacl about the treatments
let patients know how well they performed
give pointers or tips about getting better results the next time
education
patient education
one on one conversation or as a presentation to a group
patient education literature
patient questions
patient questions often create patient education situations
be prepared to answer these questions:
how did i get it?
how long will it last?
am i going to die?
is it curable?
will i need medication? will i need surgery?
will i be the same after i have recovered?
one on one conversations
in one on one situations, health care workers must teach patients about procedurres, therapy, and equipment
make sure patients full understand what is expected of them
group presentation
health care workers may be required to deliver presentations for patient education purposes
to prepare, health care workers should ask the following questions:
who is the audience
what is the audience’s interest in the topic
should the presentation be formal or informal
are supporting materials necessary
what type of audio visual will be most effective
DOCUMENTATION
types of documentation
many types of documentation anf they vary from one agency to another
some standard documentation includes:
health histories
notes
initial evaluations
progress reports
discharge reports
health histories
provides the doctor with important informatoon about the patient
health histories generally include:
general statistical data
cheif complaint
present illness
review of systems
past history
family history
personal/sociocultural history
SOAP notes
SOAP is an acronym for
subjective
objective
assessment
plan
all employees know where to look for information and in what format they will find it
eliminate some excess writing and reading for health care workers
narrative notes
tells the patient’s storu
chronological order
can descrive how a patient;s satus, treatment, etc. has changed
more time consuming than the soap method
initial evaluation
groundwork for a patients file
an initial eval includes:
patient identification info
refferal information: reason, referral info: reason, referral history, referral diagnosis, requested treatment, complicating factors
evaluation
diagnosis with rationale for treatment
treatment plan: prescriptions, follow up appointments, frequency and duration, goals
progress report
contains infor regarding a patients on going care, treatment, and progress
occur over a specified length of time, which can be days, weeks, months, etc.
support and give evidence of the need for the patients continued med care
progress reports should include:
patient info
current eval
diagnosis
treatment
assessment
complications
reccomendations, changes, goals
discharge report
a discharge report has two functions:
it releases the patient back to their regular lifestyle, sometimes with restrictions
it gives record of the interactivity among the health care providers, as it documents the patients success from the initial evaluation to release
discharge reports should contain the following info:
patient info
final eval
diagnosis
assessment
complications
recommendations and goals
reporting
documentation guidelines
use a black ink pen
write neatly and concisely
always include signature
correct errors appropriately
do not leave empty spaces
record items in chronological order
only use abbreviations that are apporved by the agency
dont record info performed or observed by another health care worker
desroy documents properly
double check for the correct patient, chart, and form
fact versus opinion
be careful to only include facts and to conceal own opinions
subjecrtive and objective observations
subjective and objective observations
subjective observations are often called symptoms. they are not seen or felt. instead they are comments or complaints made by the patient
objective observations are typically called signs. they can be measured or seen
eleciting info
know how to ask the right questions in order to get the info
ask broad questions that encourage patients to reply with more than yes or no answers
confidentiality
this info that goes into a patient’s file is confidential
be sensitive to confidentiality:
ask patients for personal info in a private enviroment
be careful to close file folders before setting them down
COMMUNICATION TECH
telephone communication
may be first commmunication patients have with a health care agency
creates and impression
telephone etiquette:
greeting
good telepjone etiquette includes a proper greeting
identify yourself the agency and possibly the department
voice
use a clear voice with a normal volu,e
vary tone, pitch, and volume for emphasis, hold the phone’s mouthpiece about one inch from the mouth
courtesy
be ploute, gracious, helpful, and considerate
use the other person’s name and say please and thank you
be careful not to interrupt the other person
attention
atmosphere arouns the telephone can be very busy and noisy
focus on the caller
taking telephone messages
pjone messages shoukd include:
the fll name of the caller w the correct spelling
the callers phine number w the area code and extension number if applicable
the best time of day to return the call
a brief message about the nature or purpose of the call
the date and time the call was reciebed
their own initals in case there are any questions about the message
test results and triage
the phone shoukd not be used to communicate bad news or complex info
the phone is often used for triage
answering machines and services
used to deliver a message to callers and record calls from patients
answering services are more efficitient in that the caller will be connected to an operator
other technolpgies
electronic communication
automatic routing telophone systems( ARU )
paging systems
cellular phones
facsimile, or fax, machines
electronic mail
automatic routing units
many telephone calls can be answered simultaniously
direct instruct the caller to press a number on the pjone key pad to reach a person or a department
paging systems
pagers beeo and display either a telephone number or a digital text message
pagers cannot be used for a two way communication
cellular phones
two way communication tools
private patient information should never be discussed using cellular phones
fax machines
used to transmit data over telephone lines
when using a fax machine:
get patient permission before faxing records
never fax financial information
contact the reciever before and after sending a fax
attach a sheet cover sheet that contains a confidentiality statement
electronic mail
communication among health care workers, agencies, and insurance companies
often takes the place of a printed interoffice communication
should never be used to communicate confidential patient info because emails can be intercepted